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Related Experiment Videos

Alternating antipyretics: is this an alternative?

C E Mayoral1, R V Marino, W Rosenfeld

  • 1Department of Pediatrics, Winthrop University Hopsital, Mineola, New York, USA. kalenamd@aol.com

Pediatrics
|May 3, 2000
PubMed
Summary

Pediatricians frequently alternate acetaminophen and ibuprofen for fever management, despite lacking scientific evidence of safety or efficacy. This practice, more common in early-career physicians, warrants caution due to potential harm.

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Area of Science:

  • Pediatric Medicine
  • Pharmacology
  • Evidence-Based Practice

Background:

  • Pediatricians face parental anxiety regarding childhood fevers.
  • Current fever management strategies vary widely among practitioners.
  • Alternating acetaminophen and ibuprofen is a common but scientifically unvalidated practice.

Purpose of the Study:

  • To identify current pediatric fever management strategies.
  • To determine the basis for these strategies.
  • To assess the frequency of alternating acetaminophen and ibuprofen use.

Main Methods:

  • A voluntary 15-item questionnaire was administered to pediatricians during professional meetings.
  • 161 completed surveys were analyzed.
  • Respondents' practice experience and fever management choices were recorded.

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Main Results:

  • Most pediatricians initiate antipyretic treatment at 101°F, with some using discomfort as an indicator.
  • Fifty percent of respondents advised alternating acetaminophen and ibuprofen.
  • Younger physicians (<5 years in practice) were more likely to alternate antipyretics (69.7%).

Conclusions:

  • Alternating acetaminophen and ibuprofen for fever is common but lacks scientific evidence for safety and efficacy.
  • Cited reasons for this practice include AAP recommendations (erroneously) and peer opinions.
  • Caution is advised due to potential harm and the absence of supporting scientific data, especially among newer practitioners concerned about "fever phobia."